Rebuilding Ukraine’s Wounded: Dr Volodymyr Staude on the Science of Military Rehabilitation
By Matthew Parish
Monday 28 September 2026
The Lviv Herald interviews the head of rehabilitation at Kharkiv’s Sytenko Institute about blast injuries, prosthetics, virtual reality, the limits of early rehabilitation and the new medical science emerging from Ukraine’s war.
Kharkiv is a city in which war and science live remarkably close to one another. The missiles and drones that have repeatedly struck Ukraine’s second city are manifestations of a new kind of warfare, but Kharkiv is also one of Ukraine’s historic centres of medicine and scientific research. At the Sytenko Institute of Spine and Joint Pathology, these two realities meet every day.
The Institute was founded in Kharkiv in 1907 as the Medical-Mechanical Institute, established originally to treat the serious industrial injuries associated with the mining and heavy industries of eastern Ukraine. It was the first Ukrainian medical institution specialising in orthopaedic and trauma care. Today it forms part of the National Academy of Medical Sciences of Ukraine and serves as its principal scientific institution concerned with diseases and injuries of the spine and joints.
The Institute’s contemporary structure reflects the breadth of its work. Its clinical divisions include emergency trauma care, reconstructive surgery, vertebrology, joint replacement, intensive care, rehabilitation and a dedicated combat-injury department. The latter represents a particularly important accumulation of expertise: the Institute has been developing specialist experience in treating the consequences of combat trauma since Russia’s war against Ukraine began in 2014.
At the centre of its rehabilitation work is Dr Volodymyr Anatoliyovych Staude, Doctor of Medical Sciences in traumatology and orthopaedics. He has headed the Institute’s Rehabilitation Department since 2007 and since 2023 has also led its scientific department for conservative treatment and clinical trials. His academic work encompasses rehabilitation, post-traumatic deformities and disorders of the spine and joints.
The war has transformed the context in which that expertise is applied. Soldiers arrive at Sytenko after mine and blast injuries, serious damage to the upper and lower limbs and complex wounds that may already have required surgery elsewhere. Some require further reconstructive operations. Others must learn again the physical habits that healthy people perform without conscious thought: standing, balancing and walking.
Yet Dr Staude’s account of military rehabilitation contains an important corrective to some of the simpler assumptions about wartime medicine. Rehabilitation is not merely a matter of starting exercise as soon as possible. Damaged tissue and bone obey biological laws that enthusiasm cannot accelerate. Modern prostheses are not solutions in themselves but components of complicated programmes involving surgeons, prosthetists, neurologists, psychologists and rehabilitation specialists. Above all, the injuries produced by this war do not always behave like their peacetime counterparts.
I met Dr Staude at the Sytenko Institute in Kharkiv to discuss what Ukrainian medicine is learning from the immense and tragic clinical experience imposed upon it by the war.
Matthew Parish: Could you introduce yourself and explain the work of your rehabilitation department during the war?
Dr Volodymyr Staude: For the last four years, during Russia’s aggression against Ukraine, we have been treating and rehabilitating patients following combat trauma. In 2022 and 2023 in particular, very large numbers of military personnel underwent surgery here at the Institute and were subsequently rehabilitated in my department.
MP: The Institute is both a clinical institution and a scientific one. What are its principal fields of work?
VS: Our principal scientific fields concern trauma and pathology of the spine and joints. The Institute occupies a leading scientific position in Ukraine in treating these conditions and our work is known internationally.
Our director, Dr Stanislav Bondarenko, represents Ukraine internationally in this field. At present the Institute occupies one of the leading positions in Ukraine in the treatment of joint pathology, both following combat trauma and in patients suffering from other diseases of the joints.
The Institute’s published history identifies Dr Stanislav Bondarenko as its director since 2023, Secretary General of the European Hip Society and Ukraine’s national representative to SICOT, the international society of orthopaedic surgery and traumatology.
MP: What distinguishes the treatment of military trauma from ordinary civilian trauma?
VS: The Institute established a specialised combat-trauma department in 2014, so we have accumulated more than ten years of experience in treating combat injuries. Accordingly, my department has also acquired very substantial experience in rehabilitating patients with combat trauma, involving injuries both to the spine and to the limbs.
MP: By the time wounded soldiers reach Sytenko, what treatment have they generally already undergone?
VS: Many of the operations performed here concern mine and blast injuries to the lower limbs, together with contractures that develop after these injuries. An important part of our work is restoring normal patterns of movement and the ordinary motor skills people require for everyday life.
MP: What injuries most frequently require specialist rehabilitation?
VS: The largest group consists of the consequences of mine and blast injuries to the lower extremities and injuries to the upper extremities. These are often accompanied by joint contractures and impaired movement of the affected joints.
MP: Modern warfare can produce combinations of blast, fragmentation, orthopaedic, neurological and soft-tissue injuries. What happens when somebody has suffered several forms of trauma simultaneously?
VS: Because ours is a specialist institution, the servicemen who come to us have often already undergone surgery in a military hospital. They are transferred here because they require a higher level of specialist care or more complicated treatment.
These patients may therefore undergo complex reconstructive surgery at our Institute. After those operations, we undertake their rehabilitation.
MP: Has the pattern of patients reaching you changed since the full-scale invasion began in February 2022?
VS: Yes. Today we receive fewer military patients requiring ordinary surgical intervention. The servicemen who now come to us tend principally to require high-technology or reconstructive surgery.
In 2022 and 2023, the majority of our patients were military personnel. Since then, the Ukrainian military medical system has significantly increased its effectiveness. As a result, fewer of these patients now need to come to us. The particularly complicated cases still do.
MP: Has the enormous expansion of drone warfare created new patterns of injury?
VS: Many such patients are treated within military hospitals and the military medical system. But the most complicated cases — and there are many of them — are referred to our Institute and subsequently undergo rehabilitation here.
MP: Because Sytenko is a scientific institute, does your experience of treating these patients feed directly into research?
VS: Yes, absolutely. We now have scientific research projects directly concerned with treating military personnel. There is an important scientific component to the treatment of these patients at our Institute and we have already published a substantial number of scientific articles arising from this work in indexed scientific publications.
MP: What is one of the principal scientific problems you are encountering in military trauma?
VS: One of the most important is that the normal periods for wound healing, bone healing and the union of fractures are different in patients with combat trauma. They are often significantly longer and the healing process is more complicated.
That is why a scientific approach to treating the wounded is so important. These cases do not necessarily fit the standards that existed before the war, or even some of the standards that exist today. We therefore need scientific research in order to develop new standards for treating these patients.
MP: Has the sheer scale of the war forced Ukrainian medicine to develop new methods more quickly than would normally happen in peacetime?
VS: Yes. We are trying to introduce new principles of treatment into clinical practice.
For example, in February this year our director, Stanislav Bondarenko, performed osseointegration procedures on four patients who had undergone above-knee amputations.
These patients had previously been fitted with conventional prostheses in 2023 and 2024, but they had been unable to use them successfully.
In February 2026 they were offered osseointegration. One of these cases was extraordinary.
I showed you the photographs and videos. This was a serviceman who had previously undergone an amputation but had been unable to use a conventional prosthesis. He underwent this modern operation in February.
By 24 April, approximately two months later, he had returned to a military training centre as an instructor. He had returned to service.
It was, for us, a small miracle.
MP: How is the experience you are accumulating recorded and shared scientifically?
VS: In March this year I presented research on the use of virtual-reality headsets in the rehabilitation of military personnel. In November I am planning to travel to Porto in Portugal to present at a congress concerned with spinal and pelvic pain.
Our director is presently attending an international congress in Kyoto, Japan, presenting work on joint replacement. At present many joint-replacement operations at our Institute are also performed for military personnel, including through state programmes.
MP: There is an understandable assumption that rehabilitation should begin as early as possible after surgery. Is that always correct?
VS: I must emphasise that the earliest possible rehabilitation is not necessarily beneficial in every case.
There are general biological laws governing the restoration and healing of tissues, including bone tissue. If those biological processes are ignored, we very often see complications. Those complications can subsequently be extremely difficult to correct and in some cases they require additional surgery.
This is another area in which the scientific component is important. We need further research into rehabilitation that respects these fundamental biological processes and we need to incorporate that knowledge into clinical practice.
MP: How should a rehabilitation programme for somebody with extremely serious injuries be organised?
VS: That is a very important question and it is now being addressed at national level in Ukraine through the development of multidisciplinary teams.
These teams bring together specialists from different fields, particularly physical and rehabilitation medicine. But our experience shows that rehabilitation specialists must work in immediate and continuous contact with traumatologists and surgeons.
Different surgical procedures require different rehabilitation schedules and different degrees of loading upon particular parts of the body. A genuinely multidisciplinary approach is therefore extremely important, but it has to involve a real dialogue between the surgeon and the rehabilitation specialists.
Unfortunately, conventional rehabilitation standards do not always work adequately in cases of combat trauma. I say this on the basis of the experience we have accumulated here while treating Ukraine’s defenders.
MP: Ukraine now has a very large number of amputees. What is required if those patients are to achieve the greatest possible independence?
VS: The need for prosthetics is enormous. There are very many patients requiring them.
Ukraine therefore needs assistance in developing facilities capable of manufacturing prostheses for these patients. This is a complicated and multifaceted problem. Again, multidisciplinary teams are important.
For military amputees, competent work by prosthetists is essential. We also need sufficient manufacturing capacity and adequate stocks of prosthetic components so that people can actually obtain the devices that restore their mobility.
MP: Does the example of osseointegration demonstrate that obtaining a prosthesis is only one part of a much more complicated medical process?
VS: Absolutely. This is a multifaceted question.
Our experience with the four patients who underwent osseointegration was particularly striking. We saw what I can only describe again as a small miracle: somebody who had been unable to walk underwent surgery towards the end of February and by April had returned to ordinary life.
Osseointegration is a new and very interesting technology. It is also a technology about which there is debate, but it can enable a person to return to ordinary life.
Conventional prosthetics can likewise restore a person’s life when they are carried out properly. We need to continue studying all these approaches. What particularly impressed me about our experience with osseointegration was seeing people return to ordinary life within two months.
MP: What about neurological injuries?
VS: Damage to major nerves occurs in a very high proportion of these patients. Therefore cooperation with neurologists and neurosurgeons is extremely important in rehabilitation. Again, this illustrates the fundamental principle of the multidisciplinary team.
MP: Mine and blast trauma can cause extraordinarily complicated damage. What are you learning about its longer-term consequences?
VS: Mine and blast trauma is extremely complex. Our experience shows that its consequences can be difficult to treat surgically and also difficult to rehabilitate.
The Institute currently has a scientific research programme studying, for example, deformities of the long bones following traumatic injury. To establish the optimal treatment algorithms for these patients, it is essential to combine scientific research with the best available international experience.
MP: Phantom-limb pain must be another significant problem.
VS: Yes. Phantom pain is a major problem and it requires further development of treatment methods. Our Institute is involved in scientific meetings concerning rehabilitation, prosthetics and osseointegration, including international expertise specifically devoted to the treatment of phantom pain.
MP: Physical recovery cannot be entirely separated from psychological recovery. How do you address that?
VS: This is also extremely important. There are two psychologists working within my rehabilitation department. They work directly with these patients and they also use virtual reality as part of their work. We have been seeing quite good results from this approach.
MP: For soldiers who were extremely physically active before being wounded, suddenly becoming dependent upon other people must be particularly difficult.
VS: Yes. For these patients the psychological dimension is extremely important in restoring their everyday activity and independence.
MP: Can apparently modest achievements — standing unaided, climbing stairs, dressing oneself or walking outside — become major milestones?
VS: Yes, absolutely. This is very important. It is a principle we use in rehabilitating our patients: step by step.
MP: Do you continue following patients after they leave intensive rehabilitation?
VS: Because we are a scientific specialist institution, after we have treated the patient that person may continue treatment on an outpatient basis or at another institution. We do not necessarily continue treating every patient ourselves.
But Ukraine has established continuity between institutions. A person who has completed treatment at one medical institution can continue the next stage at another.
MP: The war has now lasted long enough that some consequences of injury may emerge years afterwards. Are you already seeing this?
VS: Yes, certainly. The consequences of military trauma will continue to be observed for years.
From a purely orthopaedic perspective, we are concerned with changes in gait patterns, altered loading of the joints and changes in postural balance. My department has a gait laboratory in which we directly study parameters of walking and posture.
Those parameters change following serious injuries and the consequences of those changes can manifest themselves years later. And that is without even discussing the psychological consequences, which are another extremely important problem.
MP: International attention naturally concentrates upon the dramatic moment when a soldier is wounded, evacuated and operated upon. Is there a danger that the months and years of subsequent medical work become invisible?
VS: In my view, good medical care does not necessarily need to be at the centre of public attention.
Ideally, somebody becomes ill or injured, receives treatment, recovers and then gets on with life. That should be normal. Unfortunately, it is often when there are negative consequences following illness or surgery that public questions arise.
If medicine is working well, it does not necessarily have to be at the centre of public attention. What is extremely important, particularly during difficult times such as these, is that medicine itself receives support. That includes appropriate salaries and social protection for medical workers. I consider this very important.
MP: Are Ukrainian specialists exchanging the experience they have gained with doctors and research institutions elsewhere in the world?
VS: Yes. As far as our Institute is concerned, doctors from our clinics communicate with colleagues in other countries. They undertake specialist training abroad and participate in international congresses and conferences not merely as members of the audience, but as speakers presenting their own research.
The experience accumulated by our Institute is of considerable interest to doctors throughout the world.
MP: Which forms of international cooperation would be most valuable: equipment, research partnerships, specialist training, exchange programmes or collaborative studies?
VS: In my view, every one of those forms of scientific cooperation is important, not merely for our Institute but for specialists throughout Ukraine. All the areas you have mentioned are important.
MP: What does sustained exposure to severe military trauma do to the doctors, scientists, physiotherapists, psychologists and nurses who treat these patients?
VS: Working with severe combat trauma is undoubtedly difficult and of course there are psychological consequences for medical personnel as well.
But in our speciality — orthopaedics and traumatology — achieving a positive result is extremely important. Seeing that positive result also helps medical workers themselves to recover psychologically. And, of course, it motivates us to achieve still better rehabilitation outcomes for our patients.
MP: When this war eventually ends, will caring for and rehabilitating Ukraine’s wounded remain one of the country’s great medical responsibilities for decades?
VS: At the present time I cannot answer that question. I do not know what the future will look like.
I hope, certainly, that our medical system and our rehabilitation system will become significantly better. But precisely how things will develop, I cannot know.
MP: Dr Staude, thank you very much for your time.
VS: Thank you. Thank you for your attention.
There is something revealing in Dr Staude’s reluctance to predict the distant future. Medicine, like war, punishes excessive confidence. His answers instead return repeatedly to evidence: what happens to bone, what happens to gait, what happens after surgery, what happens when established rehabilitation schedules prove unsuitable for the injuries produced by mines and explosives.
The result is a picture of Ukrainian military medicine rather different from the dramatic images ordinarily associated with battlefield casualty care. Saving a wounded soldier’s life may happen over minutes or hours. Reconstructing that person’s body and independence can require months, repeated operations and the combined work of surgeons, neurologists, prosthetists, physiotherapists, psychologists and scientists.
There is also a broader scientific consequence. Ukraine is accumulating expertise in blast trauma, complex reconstruction, amputation and rehabilitation that nobody would have wished it to acquire. Yet the knowledge exists nonetheless, purchased at an appalling human price. The responsibility of institutions such as Sytenko is to transform that experience into medicine: into research, better protocols and international scientific cooperation that may ultimately help patients far beyond Ukraine.
Perhaps the most memorable phrase in my conversation with Dr Staude was also the simplest. Rehabilitation proceeds, he said, “step by step.” For a seriously wounded soldier those words are literal before they become metaphorical. The first step may be agonisingly difficult. The next may be easier. Eventually, as in the extraordinary case Dr Staude described, those steps may lead all the way back to a military training centre and a renewed life of service.
That is the quiet science being practised in Kharkiv.
